Oral speculum



Jilly 19, 1949. R. J. MclVOR 2,476,675

ORAL SPECULUM Filed Dec, 15, 1945 v INVENTOR. ROBERT J M /1/0/? PatentedJuly 19, 1949 UNITED STATES PATENT OFFICE ORAL SPECULUM Robert J.McIvor, Piedmont, Calif. Application December 15, 1945, Serial No.635,140

This invention relates to instruments used in propping the jaws open andin depressing the tongue during extended oral inspections or operations.

It is an object of the invention to provide an oral speculum designed toafford improved protection to the patients teeth against any cracking orchipping thereof, which may occur in the use of conventional devices ofthis nature during sudden unconscious muscular contractions orconvulsions which usually occur when the patient is under generalanesthesia, and which will afford equal protection againsttraumatization of the mouth tissue which the comparatively sharp edgesandcorners of presently available devices of this class are capable ofcausing.

Another object of the invention is to provide a device of the characterdescribed designed to afiord a minimum of obstruction to the view intothe oral cavity or to the manipulation of instruments therein oradjacent to the cavity.

A further object of the invention is to provide an oral speculumcomposed of a minimum number of parts so constructed that they may beeasily kept thoroughly clean and sterile.

Still another object of the invention is to provide a device of thenature referred to which will permit of a certain degree of positionaladjustment in the oral cavity without sacrificing any of its efficiencyas a jaw :prop and tongue depressor.

The invention possesses other objects and features of advantage which,together with the foregoing will be specifically set forth in thedetailed description of the invention hereunto annexed. It is to beunderstood that the invention is not to :be limited to the particularform thereof herein shown and described as various other embodimentsthereof may be employed which come within the scope of the appendedclaims.

Referring to the drawing:

Figure 1 is a front perspective view of the speculum of my invention asapplied'to a patients mouth.

Figure 2 is a side elevational view of the speculum alone.

Figure 3 is a horizontal sectional taken in the plane, and in thedirection, indicated by the line 3-3 of Figure 1.

The structure shown in Figure 1 comprises a unitary piece of sheet metalprovided with a medial bend 4 to form a substantially horizontal spatulaportion 6 and a substantially perpendicular shank portion 1. The spatulaor depressor 6, which is adapted to enter the oral cavity 8 insuperposed relation above the tongue 9, is formed, in top plan aspect,as an elongated oval, narrower 3 Claims. (Cl. 12812) to a certain degreethan the tongue and in side elevational aspect, as shown in Figure 2, isshaped with a flat frontal portion adjacent the bend 4' and with adownwardly curved rear portion for approaching or entering the throat II. Such shaping of the spatula provides for comfortable conformationthereof to the patients tongue when the latter is forcibly depressed andalso causes the forward and sidewise displacement of the tissue at thebase of the tongue, which is desirable to provide the maximum opening ofthe throat and to reduce visual obstructions, without causing undue ordiscomfortable crowding of the tissue.

On the shank portion 1, is mounted for slidable movement a sleeve l2 towhich is attached, at the latters top end, an upper jaw engagementmember comprising a piece of comparatively stiff recoilable wire formedinto a closed loop and having its joined ends suitably bonded, by a weldor braze l3, to the sleeve l2. The shape of the upper jaw loop is rathercomplex and may best be described when viewed successively from frontand side elevational aspects. In the former aspect, as shown in Figure1, the loop is symmetrical about its vertical centerline and the wire isprovided with a comparatively sharp upward and outward bend [4, adjacentthe weld l3, which is continued upwardly and outwardly as a sweepingentrant bend l6 merging into a straight tangential portion I! whichrises angularly toward the centerline and continues into an upwardlyprotruding apex portion l8 intersecting the centerline. In the latteraspect, the wire, forming the sections of the loop lying on therespective sides of the vertical centerline of Figure 1, is bentcorrespondingly and curves rearwardly from the weld IS in an entrantcurve l6 which continues into the straight portion I! and thence isabruptly bent angularly rearwardly to form the apex portion l8. Both theapex portion I8, and the loop portions extending laterally therebeyond,are covered with a section I9 of soft rubber tubing or other similarmaterial possessing resilient characteristics. The formation of the loopis such that, when the spatula 6 is properly placed on the patientstongue and the sleeve [2 is elevated along the shank portion 1, thecorresponding portions of apex [8 of the loop will engage the upper jawat the interstitial recesses between the canine and first molar teeth oneach side of the mouth and the bends I6 will lie substantially againstthe patients cheeks. This will place the parts of the speculum back outof the way where they will not interfere with the free use of examiningor operational instruments in or around the oral cavity and will provideupper bearing points which are materially stronger than the incisorbearing points employed by conventional specula. During an operation,when the patient is under general anesthesia, muscular twitching andforceful contractions may occur which, when conventional types ofspecula are used, may cause chipping and cracking of the teeth engagingthe speculum and often severe traumatization and bruising of the mouthtissue. Such injuries may be caused, in the case of the teeth, byabnormal pressure of the latter against unyielding surfaces orcomparatively sharp protuberances of the device, by faulty design anddistribution of bearing points in the speculum used, or by lateralmovements of the jaws relative to each other and to the speculum. Fleshwounds may likewise occur by accidental pinching of tissue between thespeculum and the teeth or by abrasion caused by comparatively sharpedges or corners of the device ruhbing with severe pressure against theflesh.

In the device of my invention, positioning of the upper jaw engagingloop comparatively far back in the patients mouth, and engaging thenatural notches existing between the opposite canine teeth and theadjacent first molar teeth, brings the upper jaw contact points and thelower jaw contact point, where the spatula bears most fully against thetongue, more nearly into vertically aligned relationship than is thecase in any other speculum of which I am aware. In the types of speculanow available, the major tongue contact occurs deep back in the mouthbut the upper jaw engagement occurs relatively far forward and usuallyin the group of relatively weak frontal teeth between the canine teeth.Should a patient wearing a device of this type clench his jaws, theresultant rocking force on the upper contact point, about the contactpoint on the tongue as a fulcrum, will be in a direction generally forwardly and outwardly of the mouth and transversely of the frontal teeth.Such stresses are frequently sufficiently severe as to dangerouslyloosen the teeth in their sockets and to crack or chip the tooth enamel.The positioning of the loop at the points mentioned overcomes this toothdamaging' tendency and it is further reduced by the presence of thepressure absorbing resilient covering [9 of the loop. Tissue protectionin the device is aiforded by the absence of all sharp edges and cornerswhich might cause damage. Furthermore, the loop form of the device givesthe speculum a certain degree of vertical compressiblity valuable ingently but firmly resisting muscular contractions.

Means is provided for securing the sleeve I2 to the shank portion 1 sothat the speculum may be locked in any of the several positions ofextension. Formed in the front surface of the shank portion are spacednotches 2|, having inclined upper sides, which cooperate with a latchlever 22 pivoted on a bracket 23, carried by the sleeve l2, and pivotedwith an inturned dog portion 24 which passes through an aperture 26formed in the sleeve to engage one of the notches 2|. A retorsely bentleaf spring 21 engaging the pivot pin 28 and bearing against the latchlever 22 and the sleeve l2 respectively serves to forcibly maintainengagement of the dog 24 with a notch 2i. To facilitate gripping of thespeculum so that the sleeve may be slid upwardly along the shankportioh, in extending the loop relation to the spatula, I provide ahoonsnaped finger hold 29 at and formed integrally with the lower end ofthe shank portion. W

The speculum of my invention above described 4 has been reduced to theultimate of practical simplicity, is capable of providing moreinstrument and observational clearance than similar presently employeddevices of this nature, and is capable of easy cleaning andsterilization.

Having thus described by invention in detail what I claim as new anddesired to secure by Letters Patent is:

'1'. In an oral speculum, a tongue-engaging spatula having a dependentshank portion, an element slidable on said shank portion, means tosecure said element and shank portion together in various positions ofrelative movement, and an upper-jaw engaging member carried by saidelement and extending above said spatula, said upper jaw engaging memberbeing so formed and positioned relative to said spatula that when thelatter is in proper position on the tongue the said member will traverseand engage the upper jaw along a substantially straight line over theopposite interstitial recesses between the canine and first molar teeth.

2. In an oral speculum, a tongue-engaging spatula having a dependentshank portion, an element movable relative to said shank portion, meansto secure said element and shank portion together in various positionsof relative movement, and an upper jaw engaging member carried by saidelement and extending above said spatula, comprising a loop ofrecoilable material having an oblique portion thereof engageable, whenthe spatula is in proper position on the tongue, with the upper jaw overthe interstitial recesses between the canine and first molar teeth, saidloop having portions extending laterally to substantially engage thecheeks beyond the transverse borders of the oral cavity, and a yieldablemember associated with said loop in the tooth-engaging portions thereofand in the laterally extending portions thereof.

3. In an oral speculum, a tongue-engaging spatula having a dependentshank portion, an element slidable on said shank portions, means tosecure said element and shank portion together in various positions ofrelative movement, and an upper jaw engaging member carried by saidelement and extending above said spatula, comprising a loop ofrecoilable material having an oblique portion thereof traversing andengageable, when the spatula is in proper position on the tongue, withthe upper jaw over the interstitial recesses between the canine andfirst molar teeth, said loop having portions extending laterally tosubstantially engage the cheeks beyond the transverse borders of theoral cavity, and a sleeve of yield able material enclosing thetooth-engaging portions oi said loop and projecting into the laterallyextending portions thereof.

ROBERT J. McIVOR.

REFERENCES CiTED The following references are of record in the file ofthis patent:

UNITED STATES PATENTS Number Name Date 1,388,421 Forgrave Aug. 23, 1921FOREIGN PATENTS Number Country Date 381,393 France Nov. 7, 1907 OTHERREFERENCES Mueller 8: Go. Catalog-4938 edition, page 119.

